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Side by Side Cancer Support: New client onboarding form

About you

Full name

Preferred name (if different)

Date of birth

Email address

Phone number (Mobile number preferred for WhatsApp support)

Are you booking support for?

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Your emergency contact name and relationship

Emergency contact phone number

GP practice name and location

About your situation.

What type of cancer do you or your loved one have? (eg. breast, bowel, lung)

What stage is that cancer (if known)

Where are you/your loved one at in the cancer experience currently

What would you like help with right now? (there's no right or wrong answer. A few words is fine)

Is there anything else that you would like me to know before we meet?

How did you hear about Side by Side Cancer Support (optional)

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B
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Side by Side Cancer Support Terms and Conditions

Mugnai Oncology Services Ltd (Trading as Side by Side Cancer Support)

1. Scope of Support & Services

Side by Side Cancer Support provides bespoke, 1-on-1 private support designed to help you navigate physical, emotional, and practical challenges during and after cancer treatment or health transitions.

Depending on your individual goals, your tailored package may combine:

Clinical Navigation & Guidance: Unhurried specialist advice on symptom management (e.g., surgical menopause, fatigue), medical treatment pathways, and preparing for medical consultations.

Cognitive Behavioural Coaching (CBC): Active, evidence-based coaching tools to manage anxiety, hypervigilance, stress regulation, pacing, and post-treatment transition.

Life after Cancer: Vocational & Practical Support: Guidance on return-to-work planning, workplace adjustments, and lifestyle adaptation.

2. Clinical Boundaries & Dual Role Declaration

Complementary Support: Services provided by Side by Side Cancer Support are designed to complement, not replace, the care provided by your NHS oncology team, GP, or primary healthcare providers.

Medical Prescriptions & Emergency Care: Rachel Mugnai provides specialist nursing guidance and coaching within her professional scope. However, this service does not include prescribing acute medications, providing emergency medical intervention, or replacing standard GP care. In the event of a medical emergency or acute clinical deterioration, you must contact your GP, NHS 111, attend A&E or call 999.

Coaching Boundary: Cognitive Behavioural Coaching (CBC) is a goal-oriented educational and self-development approach. It is not formal psychotherapy or acute psychiatric treatment.

3. Fees & Sessions

Hourly Rate & Investment: Services are billed at £85 per hour.

Session Duration: Standard sessions are 60 minutes in duration and conducted via secure Google Meet video call unless otherwise agreed. (or in person in the North East by arrangement.)

What is Included in Your Fee:

1-on-1 dedicated clinical navigation, specialist advice, and/or coaching time (60 minutes per session).

All personalised frameworks, symptom tools, reflection guides, and recommended information materials provided during or following the session.

Messaging between sessions After each session, you can message me on WhatsApp for seven days with any questions that come up. I usually reply within one working day, Monday to Friday. WhatsApp is for short questions and practical messages. Anything more detailed is best saved for a session. WhatsApp is not for urgent or medical problems. For those, please contact your hospital team, call NHS 111, or call 999 in an emergency.

Payment Terms: Invoices are presented prior to scheduled sessions and must be paid in advance via bank transfer to confirm and secure your booking.

4. Scheduling, Cancellations & Rescheduling

Session Appointments: Sessions are conducted via secure Google meets video call unless otherwise agreed.

Cancellation and changes: If you need to cancel or move a session, please give at least 24 hours’ notice and I’ll rebook it or refund you in full. Cancellations with less than 24 hours’ notice may be charged at 50% of the session fee. If I ever need to cancel, I’ll offer you a new time or a full refund.

Punctuality: Sessions will begin and end at the scheduled time. If you arrive late, the session will still conclude at the original end time to respect subsequent appointments.

5. Confidentiality & Your Data

Confidentiality & Its Limits

All information shared during our sessions is strictly confidential and will not be disclosed to third parties without your explicit consent. However, confidentiality must be broken under the following exceptional circumstances:

Safeguarding & Harm: If there is a clear and immediate risk of serious harm to yourself or others.

Legal Obligations: If required by a court of law or under mandatory reporting legislation.

Clinical Safety Protocols: If your psychological distress reaches a level where clinical intervention is required, I reserve the right to contact your nominated emergency contact or healthcare team (e.g., General Practitioner or Oncology Clinical Nurse Specialist). By signing this agreement, you give me permission to contact your primary clinical team, GP, or hospital specialists if we agree it is necessary for the safe, coordinated management of your care. Where possible, any steps taken will be discussed with you first.

Your Information

Your form answers are collected through Tally and then stored securely in Halaxy. Messages between sessions are sent on WhatsApp, which is end-to-end encrypted. You can read how I look after your information in my privacy policy: Privacy & Data Protection Policy | Side by Side. You can ask to see, correct or delete your information at any time.

Session transcription With your agreement, I may use Google Meet’s transcription during video sessions to help me write accurate notes. It’s completely optional, and you can say no, or ask me to stop it at any time, without it affecting your support. Sessions are never video or audio recorded. Transcripts are used only to write your notes and are permanently deleted within 7 days.
6. Professional Governance & Insurance

All services provided by Side by Side are fully covered by professional indemnity and medical malpractice insurance, and strictly adhere to the Nursing and Midwifery Council (NMC) Code of Conduct.

Side by Side Cancer Support — Client Agreement

Declaration & Confirmation

By ticking the boxes, typing my name and signing below, I confirm that:

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